Thyroglossal cyst with cancer

[saraesa]

Hi, I have just undergone a removal of a thyroglossal cyst. The pathology report found that there was papillary carcinoma cells on the wall of the cyst. It appears that the thyroid glands are normal. The doctors say that this condition is extremely rare and my doctor, who is a general surgeon has never seen such a case before. My questions are:
1. My surgery was 3 days ago but I still some pain in my throat, and I have a terrible cough. Is this normal? Or should I get antibiotics?
2. I have been advised to do iodine radiation therapy. But apparently, this will ruin my  thyroid and I will have to be on hormone pills for life. The therapy is also supposed to kill off any remaining cancer cells. Is this the normal procedure for cases like mine? Or is the doctor being overly cautious?

Just for some background, when I first saw the doctor he was very confident that it was just a simple thyroglossal duct cyst. He was even confident after the surgery and was taken aback when the pathology results came back. Is there any chance that because of his confidence he did not check other areas for cancer as well during the surgery and that is why they now want me to go for radiation therapy?

appreciate your speedy reply since I have to make decision fairly soon.

[utahmomma]

Usually if any thyroid cancer is found (and papillary carcinoma is a thyroid cancer) then a complete TT is recommended.  There are often micro cancers in other areas of the thyroid associated with papillary carcinoma.  I would talk to a good endocrinologist who specializes in thyroids (most specialize in diabetes) and perhaps an oncologist before you have RAI without additional surgery.

[saraesa]

Hi there,

I think because the cancer appeared to be only on the thyroglossal cyst wall, which is not on the thyroid itself, they are saying that there is no need to get rid of the thyroid. Is it a matter of not wanting me to undergo another operation? The doctor said that it doesn't appear like the cancer has gone onto the thyroid, and the thyroid looks fine. I don't see the difference since an RAI will kill my thyroid anyway. So you are saying RAI is only indicated after all surgery that ought to be carried out is carried out?

[utahmomma]

I am curious as to why they didn't remove the thyroid when they found the cancer?  I had a similar experience in that they found cancer in a lobe after they had removed it then they had to remove the other half before I could have RAI.  

The RAI will kill off the cancer cells but it will also kill your thyroid.  Usually with cancer it is not indicated until the thyroid gland has been removed.

Papillary carcinoma can often be multi-focal and made up of lots of micro-cancers.  My thyroid was removed yet two years later I developed a cancer recurrence (as indicated on TSH and Tg tests) and had to have the RAI to kill off the remaining thyroid tissue - and cancer.

You might want to ask a few questions and consult with an endocrinologist.

Utahmomma
papillary carcinoma +3 sisters with it too